Medical care

6:07 pm

Mon September 19, 2011

NW medical school doctors paid by drug companies

Some medical students are calling for Northwest doctors to be banned from taking speaking fees from drug companies.

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Some doctors on the faculty of Northwest medical schools are getting paid by pharmaceutical companies to give talks on new drugs.

Harvard and Stanford have banned this practice. But not Oregon Health and Science University or the University of Washington. Now some medical students want similar bans here.

OHSU and the UW get hundreds of thousands of dollars from pharmaceutical companies to conduct clinical trials on new drugs.

“Overwhelmingly there’s an interest in having faculty partner with the pharmaceutical and medical device industries to create products that will help save the lives of patients," said Charles Ornstein, a senior reporter at ProPublica, an investigative reporting non-profit in New York.

He says sometimes though the relationship between medical school doctors and drug companies goes beyond research to include speaking and consulting. ProPublica has created a datatbase of drug maker payments to individual doctors.

“I think that there’s concern about doctors playing a role in the marketing and promotions of new products,” Ornstein said.

AMA advises against it

A 2006 article in the Journal of the American Medical Association recommended medical school faculty – as leaders in medicine – not participate in so-called speakers bureaus. Nonetheless some doctors defend the practice.

“I am providing information, but that’s where it ends. I’m not telling people to use one drug over another,” said Dr. Alan Sandler, a lung cancer specialist at Oregon Health and Science University.

He’s one of nine OHSU faculty – along with one UW doctor – who are listed in ProPublica’s “Dollars for Docs” database as having received pharmaceutical company payments in the past three years. In a typical scenario, Dr. Sandler says he gets paid to meet with other cancer specialists to talk about a new drug where he was the lead investigator or at least involved in the clinical trials.

“I’m basically speaking on behalf of a study that was done independently of the pharmaceutical company and just presenting the data as it is,” Sandler said.

School policy vs reality?

At both OHSU and UW, doctors who give these paid talks must first get approval, disclose the payments and there are rules of engagement. Dr. Gary Chiodo is OHSU’s chief integrity officer. He explains his school’s policy.

"It has to be of genuine academic or educational value so we don’t allow people to do speaking that’s just soley promotive of a product or a company.”

Dr. Chiodo also says this about paid speaking gigs: “You may not present something that is handed to you by the company. So the work has to be your own.”

But that didn’t jibe with what OHSU oncologist Alan Sandler said. In an interview, he talked about a new lung cancer drug Pfizer has developed that most doctors don’t know about.

“So what Pfizer will do in conjunction with the FDA and following Pharma guidelines will have slides that are prepared for physicians – those that have used the drug – to talk to those that have not used the drug,” Sandler said.

And, he said, this was something he was doing.

Dr. Chiodo said it’s okay for doctors to present drug company PowerPoint presentations if they’ve helped contribute to the content of the slide deck.

Students against the practice

This flexibility in the policy doesn’t sit well with fourth year OHSU medical student Lee Shapley. He spoke to me via Skype.

“You have to be vigilant with these things, you can’t be wishy-washy about them or else the policy will be taken advantage of,” Shapley said.

It just so happens Shapley directs the American Medical Student Association’s national scorecard. It grades medical schools on their conflict of interest policies. Last year, OHSU and UW received B-grades. Shapley would like to see his school adopt an outright ban on paid speaking.

“If Harvard is doing it, if Stanford is doing, why is it a problem for us to look at it too?” he said.

OHSU defends its current policy. The UW says it will likely review its policy on paid speaking in the near future.